Outsourcing Medical Care—A Better Deal for Business?

For Americans who undergo nonemergency procedures overseas, insurance coverage is still the exception to the rule. Liability is one concern. But as the health travel trend grows and U.S. medical costs skyrocket, insurers—and employers—are testing the waters.

Some pioneers:

United Group Programs, Inc., a consultant and third-party administrator of employer health plans based in Boca Raton, Fla., offers insurance for patients at a handful of overseas hospitals at a sharply reduced cost to the employer. Patients pay no deductibles or copayments. Nearly 50 companies, ranging in size from 150 to 100,000 employees, have signed on, says Jonathan Edelheit, vice president of United Group.

Patients must sign liability waivers, but their follow-up care at home is covered, Edelheit says. United Group is also launching an international preferred provider organization with negotiated discounts at participating hospitals, and it plans to introduce financing for individuals seeking medical care abroad.

BlueCross BlueShield of South Carolina offers coverage to its 1.5 million members for major procedures performed at Bumrungrad International Medical Center in Bangkok. The plan, offered through a subsidiary called Companion Global Healthcare, will soon expand to include a hospital in Europe, and possibly in Singapore and India, says David Boucher, the insurer's assistant vice president for health care services.

Blue Shield of California and Health Net of California offer inexpensive "cross-border" policies allowing members to get care in Mexico.

Legislators in West Virginia and Colorado recently introduced bills that would give state employees cost-saving incentives under their health plans to travel overseas for major procedures.

But going abroad for treatment isn't always an easy sell. When Blue Bridge Paper Products of North Carolina proposed to send an employee to India for surgery last year, the United Steelworkers (USW) union objected, and the plan was dropped. Stan Johnston, director of the USW's District 9, says a major worry was that eventually insurers might mandate travel abroad as a cost-saving measure.

"Let's assume that it was your 80-year-old mother or 3-year-old grandchild who was being outsourced to India or Thailand," he says. "That puts a whole different dynamic on the circumstance, and people need to think deeply about what this means."